Improving Outcomes in Social Services Through Routine Outcome Monitoring and Systematic Client Feedback

Karolinska Institute

Status: Enrolling

Conditions: Family Communication; Domestic Violence; Substance Use Disorders; Child Behavior Problem; Criminal Behavior; Housing; Everyday Activities; Family Conflict; Social Care

Treatments: Behavioral: Feedback informed treatment (FIT); Behavioral: Treatment as usual (TAU)

Study type: Interventional

Funder types: Other

Identifiers

NCT07303608

2025-00833-01

2023-01738 (Other Grant/Funding Number)

Details and patient eligibility

About

In this project the investigators want to test whether a new method FIT (Feedback informed treatment) can improve the interventions people receive through social services. The FIT method involves regularly providing information about how the client think things are going and what the client thinks about the help and care they receive.

Full description

A randomized controlled trial conducted in social services' outpatient care, addiction care and in residential treatment. In addition to direct effects of using FIT (Feedback informed treatment), cost-effectiveness, instrument psychometrics and predictive value will be examined. The project include outcome measures for quality of life, behavior and symptoms which have been selected in collaboration with representatives of the users (social workers and clients). The project will also examine both clients' and social workers' experiences of giving and receiving feedback using FIT, as well as examine factors that influence implementation within social services.

Social services have an ambition to use evidence based practice, but there is a lack of methods that can help social workers and the social service to systematically follow and adapt the interventions based on the clients' situation, context and preferences. FIT is an internationally proven system for doing this. If findings of the current project are positive, it can be spread within social services through an existing network of practitioners and with existing digital tools.

Participating units with experience and interest in FIT will be recruited in collaboration with the Swedish FIT network and with already engaged municipalities and treatment units. The project will ensure that participating social workers have sufficient skills and that their workplace is ready to work with FIT. Clients who are granted treatment at the unit will be asked if they want to be included in a study where they can give feedback on the interventions they receive and help to follow their progress. After baseline, they will be randomized to treatment as usual or treatment with the addition of FIT. To support implementation, the therapists in the FIT group will be offered regular supervision.

Enrollment: 400 estimated patients

Sex: All

Ages: 15+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

People who have been granted assistance under the Social Services Act at includes centers.

Exclusion criteria

• People who do not have sufficient knowledge of Swedish or have impaired cognitive functions that prevent them from using FIT in Swedish, as they cannot benefit from the intervention that the study intends to evaluate the effects of. This is assessed by the respective social service.
• People who receive support and treatment interventions that are not voluntary, i.e. interventions according to the Act on the Compulsory Care of Young People (LVU) or the Act on the Compulsory Care of Drug Abusers (LVM)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Feedback-informed treatment (FIT)

Experimental group

Description:

Feedback-informed treatment (FIT) added to treatment as usual. The social workers will use FIT together with the participant at each visit or unit of service (week) The components of FIT is administrating the Outcome Rating Scale at the beginning of session and Session Rating Scale at the end of the session, calculating and interpreting the values (digitally or manually) as well as discussing the results, trying to create a culture of feedback (actively seek and value honest client input).

Treatment:

Behavioral: Treatment as usual (TAU)

Behavioral: Feedback informed treatment (FIT)

Treatment as usual (TAU)

Active Comparator group

Description:

Treatment as usual at social services without the use of the components in Feedback informed treatment.

Treatment:

Behavioral: Treatment as usual (TAU)